摘要
目的 探讨食管胃吻合术后胃排空障碍的原因、合理的预防措施及其有效的治疗方法。方法 回顾性分析我科 1982年 1月～ 2 0 0 2年 4月间 32例食管胃吻合术后胃排空障碍病人的临床资料。结果 32例胃排空障碍病人 ,食管胃颈部吻合 2 4例 ,胸腔内吻合 8例。占同期食管癌手术 1378例的 2 .3%。 2 5例功能性胃排空障碍病人中 2 2例经保守治愈 ,1例死亡 ,死亡率为 4 .0 % ;7例机械性胃排空障碍病人经手术治愈。结论 胃排空障碍多见于高位食管胃吻合术后 ,以食管胃颈部吻合者多见 ,其发生与手术操作和术后处理不当有关 ,胃排空障碍多为功能性 ,少数为机械性。前者大多可经保守治疗而痊愈 ,后者则必须手术解除梗阻。本文还对食管癌术后胃排空障碍的定义。
Objective To evaluate the incidence of delayed gastric emptying after esophagectomy and investigate methods to treat and prevent it. Methods From January 1982 to April 2002, data of 32 patients with delayed gastric emptying after esophagectomy were studied retrospectively. Results The incidence of delayed gastric emptying after esophagectomy in 2 427 patients with esophageal cancer was 2.3%. There were 25 functional and 7 mechanical disorders. 25 patients with functional gastric emptying disorder recovered after non-surgical treatment. All the mechanically obstructive cases were treated surgically. Of the 32 patients with delayed gastric emptying, 24 had esophagectomy with cervical anastomosis, 7 had intrathoracic anastomosis. The mortality rate was 9.3%(3/32). Conclusions Most of gastric emptying disorders were functional and often developed in the patients with cervical anastomosis. Because the obstructive cases require surgical intervention and the functional ones may recover after non-surgical treatment, it is important to identify the different types. In order to prevent the obstructive gastric emptying disorder, surgical technique should be considered carefully during esophagectomy.
出处
《消化外科》
CSCD
2004年第1期43-45,共3页
Journal of Digestive Surgery
关键词
食管癌
外科治疗
食管胃吻合
胃排空障碍
esophageal carcinoma surgical treatment esophagogastrostomy gastric emptying
